US cost warning over drugs to treat "normal" ageing

Prescription drug treatment regimens for conditions that are a normal part of ageing are now costing the US more than many serious and potentially life-threatening conditions, new research shows.

Last year, spending on medications for ageing conditions - such as mental alertness, sexual dysfunction, menopause, ageing skin and hair loss - ranked third in annual prescription drug costs of commercially-insured US citizens, surpassed only by the cost of treating diabetes and high cholesterol, says the study, published by pharmacy benefit manager (PBM) Express Scripts.

Among these insured individuals, the use of drugs to treat the physical impact associated with normal ageing was up 18.5% from 2006 to 2011, and costs increased nearly 46%, says the research, which has been presented at the annual meeting of the American Public Health Association (APHA) in San Francisco.

Moreover, increased use of these drugs has been even more pronounced among enrollees in Medicare, the US federal health care programme for people aged 65 and over (and which also covers some people with disabilities). For Medicare beneficiaries, use of these drugs increased 32% during 2007-2011, and from 2010 to 2011 the increase was more than 13%, outpacing growth in the use of drugs for diabetes, high cholesterol and high blood pressure combined, it says.

Also, in 2011 alone, more than $73.3 million was spent for every one million commercially-insured Americans, and the cost was nearly $90 million per one million Medicare members on these ageing-related medications.

Express Scripts points out that the US is in the midst of a profound demographic change, with the number of elderly people projected to reach nearly 20% of the entire population by 2030, up from less than 13% in 2009. This increase will continue to drive both use and costs of medication to treat the natural conditions of ageing, it says.

The study also showed that while utilisation and drug costs were highest among older commercially-insured individuals, the greatest growth in cost per insured person was seen among the 45-54 age group, rising almost 21% over the five-year period.

Express Scripts points out that the study analysed prescription medications only, and it therefore may underestimate the total costs of ageing treatments, which include a variety of over-the-counter (OTC) medications, cosmetic treatments and surgery.

Meantime, other new research find that US per capita Medicare spending on the elderly grew 198.7% during 1980-2009 in the US, compared to growth in Canada of just 73%.

Had US Medicare spending per elderly enrolee increased as slowing as in Canada, the savings during 1980-2009 would have totalled $1.156 trillion, equivalent to more than one-sixth of the US national debt, say the researchers, reporting their findings this week in the Archives of Internal Medicine.

Among the reasons for Canada’s better record on cost-containment are, they say: - less paperwork and administrative bloat;” - the use of lump-sum budgets for hospitals; - stringent controls on spending for new buildings and expensive new equipment; - the use of single-buyer purchasing power to rein in drug and device prices; - relatively low litigation and malpractice costs; and - an emphasis on primary care.